[Importance of self-assessment of functional and communication abilities on the outcome of rehabilitation in patients with hemiplegia after cerebrovascular stroke].

INTRODUCTION

Cerebrovascular insult causes focal damage of the central nervous system structures consequently causing loss or disturbance of their functions. Motor deficit is often associated with personality alterations generally speaking, as well as changes in behavior and loss of numerous neuropsychological functions. Rehabilitation of such patients should be defined by all members of the team, including the patient himself and members of his family.

MATERIAL AND METHODS

This is a case report on a male patient 49 years of age with rightsided paralysis accompanied by aphasia. Thirty days after cerebrovascular insult he was transferred from the Clinic of Neurology in Novi Sad to the Clinic of Medical Rehabilitation. Functional disability assessment was made using Barthel Index, whereas communication was assessed by Boston Diagnostic Aphasia Examination. The rehabilitation program included, apart from the usual team, the patient himself and members of his family. The patient became the center of the team and was informed about the disease. Personal assessment of the patient on his functional and communication abilities and their importance for further progress was used to set the objectives of the rehabilitation program. The rehabilitation program was performed by a speech therapist and a psychologist, including kinesis, work activities, occupational therapy, individual and group therapy.

RESULTS

The outcome of the rehabilitation program in this patient was significantly better than expected.

DISCUSSION AND CONCLUSION

This case report shows that being the center of the rehabilitation team the patient takes an active part in setting objectives of the rehabilitation program, whereas involvement of the family, knowledge on necessary medical issues about the disease, contribute to better motivation and better outcome of the rehabilitation program in patients with hemiplegia caused by cerebrovascular insult.